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Objectives: During circulatory failure, the ultimate goal of treatments that increase cardiac output is to reduce tissue hypoxia. This can only occur if oxygen consumption depends on oxygen delivery. We compared the ability of central venous oxygen saturation and markers of anaerobic metabolism to predict whether a fluid-induced increase in oxygen delivery results in an increase in oxygen consumption.

Conclusions: In volume-responders, unlike markers of anaerobic metabolism, central venous oxygen saturation did not allow the prediction of whether a fluid-induced increase in oxygen delivery would result in an increase in oxygen consumption. This suggests that along with indicators of volume-responsiveness, the indicators of anaerobic metabolism should be considered instead of central venous oxygen saturation for starting hemodynamic resuscitation.

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Professors Monnet and Teboul are members of the Medical Advisory Board of Pulsion Medical Systems. The authors received funding from Assistance Publique des Hôpitaux de Paris. Drs. Monnet and Teboul consulted for Pulsion Medical Systems. The remaining authors have not disclosed any potential conflicts of interest.